Active NPI
Ninedty Cordova Muniz, APRN
- Adult Medicine Physician
- Miami, FL
National Provider Identifier
1689389686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 11023623
- Practice address
- 1490 NW 27TH Ave Ste 130
Miami, FL 33125-2173 - Phone
- (305) 635-7710
- NPI assigned
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 11023623 | FL | Primary |
Addresses
Primary practice location
1490 NW 27TH Ave Ste 130
Miami, FL 33125-2173
Mailing address
1490 NW 27TH Ave Ste 130
Miami, FL 33125-2173
Phone (305) 635-7710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230927002207 | FL | Practitioner - Nurse Practitioner | 6608220462 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11023623 | FL | MD | Adult Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Rehab Center Inc | Single Specialty | Current | Accepting new patients |
Locations
2460 SW 137th Ave
Ste 243
Miami, FL 33175
Phone (305) 640-8487
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1689389686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1490 NW 27TH AVE STE 130",
"city": "MIAMI",
"state": "FL",
"postal_code": "331252173",
"telephone_number": "305-635-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 NW 27TH AVE STE 130",
"city": "MIAMI",
"state": "FL",
"postal_code": "331252173",
"telephone_number": "305-635-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA MUNIZ",
"first_name": "NINEDTY",
"credential": "APRN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": "FL",
"license": "11023623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.